Application of Serum sFlt-1/PlGF Ratio Combined with Uterine Artery Blood Flow Ultrasound in Predicting Early-Onset Preeclampsia.

IF 2.6 4区医学 Q2 OBSTETRICS & GYNECOLOGY

International Journal of Women's Health Pub Date : 2025-08-15 eCollection Date: 2025-01-01 DOI:10.2147/IJWH.S539946

Han Zhang, Cui Xu

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Abstract

Objective: This study aimed to evaluate the predictive efficacy of combining serum soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio with uterine artery Doppler ultrasound for early-onset preeclampsia (PE) before 34 weeks' gestation.

Methods: A retrospective cohort analysis was conducted on 148 singleton pregnancies (control group: n = 76; early-onset PE group: n = 72) who delivered at our institution between July 2023 and June 2024. At 24-28 weeks, serum sFlt-1 and PlGF levels were quantified via electrochemiluminescence immunoassay (Roche Elecsys^®), and uterine artery pulsatility index (PI), resistance index (RI), and systolic/diastolic ratio (S/D) were measured by Doppler ultrasound (M22 system, standardized settings). Logistic regression and receiver operating characteristic (ROC) curves assessed predictive performance.

Results: Compared to controls, PE patients exhibited significantly elevated sFlt-1 (24.02 ± 6.68 vs 16.38 ± 7.47 μg/L; P < 0.001), reduced PlGF (1.22 ± 0.14 vs 1.54 ± 0.30 μg/L; P < 0.001), and higher sFlt-1/PlGF ratio (20.76 ± 7.71 vs 10.11 ± 4.10; P < 0.001). Doppler indices were markedly increased in PE: PI (1.34 ± 0.26 vs 0.82 ± 0.11; P < 0.001), RI (0.78 ± 0.12 vs 0.51 ± 0.07; P < 0.001), and S/D (3.89 ± 0.97 vs 2.11 ± 0.41; P < 0.001). Multivariate analysis confirmed all parameters as independent predictors (P < 0.05), with sFlt-1/PlGF ratio having the highest odds ratio (OR = 1.332, 95% CI: 1.128-1.573). The combined model achieved superior predictive performance: area under curve (AUC)=0.954 (95% CI: 0.92-0.99) vs sFlt-1/PlGF alone (AUC = 0.887; P = 0.003) or PI alone (AUC = 0.821; P < 0.001), with sensitivity 82.2%, specificity 96.7%, and accuracy 94.7%.

Conclusion: Integration of sFlt-1/PlGF ratio and uterine artery Doppler parameters (particularly uterine artery PI and RI) significantly enhances early-onset PE prediction, providing a robust tool for clinical risk stratification.

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血清sFlt-1/PlGF比值联合子宫动脉血流超声预测早发性子痫前期的应用

目的：探讨联合血清可溶性纤维样酪氨酸激酶-1/胎盘生长因子（sFlt-1/PlGF）比值与子宫动脉多普勒超声对妊娠34周前早发性子痫前期（PE）的预测效果。方法：对2023年7月至2024年6月在我院分娩的148例单胎妊娠（对照组76例，早发性PE组72例）进行回顾性队列分析。在24-28周时，通过电化学发光免疫法（Roche Elecsys®）定量血清sFlt-1和PlGF水平，并通过多普勒超声（M22系统，标准化设置）测量子宫动脉脉搏指数（PI）、阻力指数（RI）和收缩/舒张比（S/D）。Logistic回归和受试者工作特征（ROC）曲线评估预测效果。结果：与对照组相比，PE患者sFlt-1显著升高（24.02±6.68 vs 16.38±7.47 μg/L, P < 0.001）， PlGF显著降低（1.22±0.14 vs 1.54±0.30 μg/L, P < 0.001）， sFlt-1/PlGF比值显著升高（20.76±7.71 vs 10.11±4.10,P < 0.001）。PE组多普勒指数明显升高：PI（1.34±0.26 vs 0.82±0.11,P < 0.001）、RI（0.78±0.12 vs 0.51±0.07,P < 0.001）、S/D（3.89±0.97 vs 2.11±0.41,P < 0.001）。多因素分析证实所有参数均为独立预测因子（P < 0.05），其中sFlt-1/PlGF比值最高（OR = 1.332, 95% CI: 1.128 ~ 1.573）。联合模型的预测效果更好：曲线下面积(AUC)=0.954 (95% CI: 0.92-0.99)，而单独使用sFlt-1/PlGF （AUC = 0.887; P = 0.003）或单独使用PI (AUC = 0.821; P < 0.001)，敏感性82.2%，特异性96.7%，准确性94.7%。结论：结合sFlt-1/PlGF比值和子宫动脉多普勒参数（尤其是子宫动脉PI和RI）可显著提高早发性PE的预测，为临床风险分层提供了有力的工具。

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来源期刊

International Journal of Women's Health OBSTETRICS & GYNECOLOGY-

CiteScore

3.70

自引率

0.00%

发文量

194

审稿时长

16 weeks

期刊介绍： International Journal of Women''s Health is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of women''s healthcare including gynecology, obstetrics, and breast cancer. Subject areas include: Chronic conditions including cancers of various organs specific and not specific to women Migraine, headaches, arthritis, osteoporosis Endocrine and autoimmune syndromes - asthma, multiple sclerosis, lupus, diabetes Sexual and reproductive health including fertility patterns and emerging technologies to address infertility Infectious disease with chronic sequelae including HIV/AIDS, HPV, PID, and other STDs Psychological and psychosocial conditions - depression across the life span, substance abuse, domestic violence Health maintenance among aging females - factors affecting the quality of life including physical, social and mental issues Avenues for health promotion and disease prevention across the life span Male vs female incidence comparisons for conditions that affect both genders.